Piette W W
University of Iowa College of Medicine, Department of Dermatology, Iowa City.
Adv Dermatol. 1994;9:3-23; discussion 24.
Diseases associated with purpura range from the most common and trivial of human afflictions to some of the most devastating and rapidly fatal syndromes known. In order to sort the simple from the sinister, it is necessary to use not only the history and general physical examination, but also various morphologic components of the purpuric lesions themselves to suggest likely pathophysiologies of hemorrhage. Findings such as erythema, livedo reticularis, size of hemorrhage, presence or absence of palpability, symmetry or retiform patterning of lesions, and presence and extent of necrosis or eschar formation all can serve as clues to the likely etiologies of hemorrhage. Effective communication about purpuric syndromes requires information regarding the likely age of lesions described clinically or histologically and a precise description of the individual elements of the lesion. Such communication would be enhanced by eliminating the ambiguity inherent in the current usage of many of the terms employed to describe such lesions. This paper presents one possible approach to better use of the information that the morphology of purpuric lesions can provide.
与紫癜相关的疾病范围广泛，从人类最常见、最轻微的病痛到一些已知的最具毁灭性、迅速致命的综合征。为了区分简单情况与严重情况，不仅需要病史和全面的体格检查，还需要利用紫癜性病变本身的各种形态学特征来提示可能的出血病理生理学机制。诸如红斑、网状青斑、出血大小、是否可触及、病变的对称性或网状形态以及坏死或焦痂形成的存在和范围等发现，都可以作为出血可能病因的线索。关于紫癜综合征的有效沟通需要有关临床或组织学描述的病变可能年龄的信息，以及对病变各个要素的精确描述。通过消除当前用于描述此类病变的许多术语所固有的模糊性，这种沟通将得到加强。本文提出了一种更好地利用紫癜性病变形态学所能提供信息的可能方法。
